中国组织工程研究

中国组织工程研究 ›› 2023, Vol. 27 ›› Issue (3): 385-390.doi: 10.12307/2023.001

• 组织工程骨材料 tissue-engineered bone • 上一篇    下一篇

新型骨水泥螺钉系统与常用方式固定迟发性椎体骨折后骨坏死模型的生物力学比较

詹  乙1，2，王  彪1，马宇立3，何思敏1，孙宏慧1，郝定均1   

  1. 1西安交通大学附属红会医院，陕西省西安市  710054；2陕西中医药大学，陕西省西安市  712046；3上海三友医疗器械股份有限公司，上海市201815
  • 收稿日期:2021-10-14 接受日期:2021-12-15 出版日期:2023-01-28 发布日期:2022-05-19
  • 通讯作者: 王彪，博士，副主任医师，西安交通大学附属红会医院脊柱外科，陕西省西安市 710054
  • 作者简介:詹乙，男，1997年生，江西省上饶市人，汉族，陕西中医药大学在读硕士，主要从事脊柱外科研究。
  • 基金资助:
    国家自然科学基金(81802167)，项目负责人：王彪；陕西省重点研发计划(2020GXLH-Y-003)，项目负责人：王彪；陕西省重点研发计划(2020SFY-095)，项目负责人：何思敏

Biomechanical comparison between a novel bone cement screw system and common surgical methods for the treatment of Kummell’s disease

Zhan Yi1, 2, Wang Biao1, Ma Yuli3, He Simin1, Sun Honghui1, Hao Dingjun1   

  1. 1Honghui Hospital, Xi’an Jiaotong University, Xi’an 710054, Shaanxi Province, China; 2Shaanxi University of Chinese Medicine, Xi’an 712046, Shaanxi Province, China; 3Shanghai Sanyou Medical Co., Ltd., Shanghai 201815, China
  • Received:2021-10-14 Accepted:2021-12-15 Online:2023-01-28 Published:2022-05-19
  • Contact: Wang Biao, MD, Associate chief physician, Honghui Hospital, Xi’an Jiaotong University, Xi’an 710054, Shaanxi Province, China
  • About author:Zhan Yi, Master candidate, Honghui Hospital, Xi’an Jiaotong University, Xi’an 710054, Shaanxi Province, China; Shaanxi University of Chinese Medicine, Xi’an 712046, Shaanxi Province, China
  • Supported by:
    National Natural Science Foundation of China, No. 81802167 (to WB); Key Research and Development Program of Shaanxi Province, No. 2020GXLH-Y-003 (to WB); Key Research and Development Program of Shaanxi Province, No. 2020SFY-095 (to HSM)

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摘要：

文题释义：
新型骨水泥螺钉系统：该新型骨水泥螺钉系统是基于Kummell病术后易于发生骨水泥移位问题而设计的一种创新性螺钉，其具有中空的骨水泥通道，通过该中空骨水泥通道结构可以实现骨水泥快速注入的效果，并且使骨水泥能更好的和椎体结合为一体，以达到骨水泥更加稳定的效果。
生物力学：是由生物学和力学共同组成的一门学科分支，是应用力学原理和方法对生物体中的力学问题定量研究的生物物理学分支，其研究范围很广泛，从系统、器官到生物整体都是其研究对象。生物力学重点研究生理和医学相关的力学问题，通过生物力学的研究可以起到指导临床工作的效果，故在当今的医学科研中得到了广泛应用。

背景：椎体后凸成形和椎体成形为创伤后椎体迟发性骨坏死(Kummell病)的主要治疗方式，但存在易于出现术中或者术后骨水泥松动移位的风险。针对此并发症，作者所在团队设计出一种新型骨水泥螺钉系统。
目的：探讨新型骨水泥螺钉系统在创伤后椎体迟发性骨坏死中的应用价值。
方法：采用15具60岁以上新鲜成年女性尸体胸腰椎标本，无骨折、畸形，均合并骨质疏松，获取T12-L2节段，建立L1节段创伤后椎体迟发性骨坏死模型，分5组修复，A组：椎体成形；B组：椎体成形联合单侧椎弓根成形模型；C组：椎体成形联合双侧椎弓根成形模型；D组：单侧新型骨水泥螺钉联合椎体成形模型；E组：双侧新型骨水泥螺钉联合椎体成形模型，每组3具标本。在六轴脊柱运动试验机上测量各模型前屈、后伸、左右侧屈以及左右旋转6个方向的三维运动力学特征。
结果与结论：①5种模型骨水泥填充良好，未见骨水泥渗漏和骨水泥移位情况；②在前屈、后伸、左右侧屈情况下，D、E组模型的骨水泥稳定性均优于其他3组模型(P < 0.05)，且在前屈状态下新型骨水泥螺钉系统填充的骨水泥具有最好的生物力学稳定性，其次是后伸状态；在左、右旋转情况下，5组模型的骨水泥稳定性相比差异无显著性意义(P > 0.05)；D、E组模型6个运动方向上的骨水泥稳定性比较差异均无显著性意义(P > 0.05)；③结果提示，对于创伤后椎体迟发性骨坏死，该新型骨水泥螺钉系统具有优于目前常用治疗方式的生物力学稳定性，且无论单侧还是双侧置钉都具有较好的效果。

https://orcid.org/0000-0001-6595-7469 (詹乙) 

中国组织工程研究杂志出版内容重点：生物材料；骨生物材料；口腔生物材料；纳米材料；缓释材料；材料相容性；组织工程

关键词: Kummell病, 胸腰椎, 螺钉, 内固定, 生物力学, 损伤, 修复, 椎体内裂隙

Abstract: BACKGROUND: Kyphoplasty and vertebroplasty, as the main treatment of Kummell’s disease, are prone to bone cement displacement during or after surgery. Concerning this complication, the authors’ team designed a novel bone cement screw system.
OBJECTIVE: To explore the application value of the novel bone cement screw system in Kummell’s disease.
METHODS: Thoracolumbar vertebrae specimens of 15 fresh female adult cadavers aged over 60 years were used, and no fractures or deformities were found in the specimens, and all were associated with osteoporosis. The T12-L2 segments were taken, and the Kummell’s disease models were made at the L1 segment, and then five type bone cement repair models were established: group A: vertebroplasty; group B: vertebroplasty combined with unilateral pediculoplasty; group C: vertebroplasty combined with bilateral pediculoplasty model; group D: unilateral novel bone cement screw combined with vertebroplasty model; group E: bilateral novel bone cement screw combined with vertebroplasty model; each group of models contained three specimens. The three-dimensional motions in the six directions of anterior flexion and posterior extension, left and right lateral bending, and left and right rotation were performed by the six-axis spine robot.
RESULTS AND CONCLUSION: (1) The five models were well filled with bone cement, and there was no bone cement leakage or bone cement displacement. (2) Under the anterior flexion, posterior extension, left and right lateral bending, the bone cement stability of the groups D and E was better than that of the other three models (P < 0.05). The novel bone cement screw system in the anterior flexion state had the best biomechanical stability, followed by the extension state. Under the left and right rotation, there were no statistical differences the between the five groups of models (P > 0.05). There was almost no significant difference in bone cement stability in the six directions of motion in groups D and E (P > 0.05). (3) For Kummell’s disease, the novel bone cement screw system has better biomechanical stability than the current commonly used treatments, and both unilateral and bilateral novel bone cement screw systems have good results. 

Key words: Kummell’s disease, thoracolumbar spine, screw, internal fixation, biomechanics, injury, repair, intravertebral vacuum cleft

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